Arjun Khadilkar
Safety and Efficacy of Cerebrospinal Fluid Drainage Catheters in Endovascular Thoracic Aortic Repair (EVTAR)

SchoolBrecksville-Broadview Heights High School


ProgramScience


MentorMaged Argalious, MD, MBA


DepartmentAnesthesiology Institute


Research
Safety and Efficacy of Cerebrospinal Fluid Drainage Catheters in Endovascular Thoracic Aortic Repair (EVTAR)
Hypothesis
Cerebrospinal fluid (CSF) drainage reduces the incidence of neurologic complications after endovascular thoracic aortic repair through increasing perfusion pressure to the spinal cord.
Methodology
We analyzed data prospectively collected utilizing the Anesthesia Institute Registry on all EVTAR cases with CSF drainage. Over a two-year period, 85 consecutive patients underwent EVTAR. Specifically, the incidence of neurologic and in-hospital mortality after EVTAR with prophylactic CSF drainage was assessed. Four out of 85 patients undergoing EVTAR with CSF drainage developed paraplegia (4.71%). In three out of the four patients, therapeutic CSF drainage (to a pressure less than 5 mm Hg) in addition to mean arterial blood pressure elevation was successful in reversing the paraplegia. One patient developed irreversible paraplegia (1.18%) despite the aforementioned interventions and one patient developed postoperative stroke (1.18%). In-hospital mortality was 7.06% (6 out of 85 patients).
Outcomes
CSF drainage in EVTAR appears to be a safe and efficacious adjunct in the reduction of incidence of irreversible paraplegia in patients undergoing EVTAR.

Interpretations

Drained by Malerie Schreiner